Bladder Cancer
Supportive Care
Advances have been made in treating cancer and also in ways to prevent and manage side effects. Your multidisciplinary health care team will use what’s known as supportive care services to address the physical, emotional, practical, spiritual and financial effects of your cancer diagnosis. Supportive care is designed to improve your overall well-being. Your family members, caregivers and others close to you can also benefit from these services.
You will work closely with a variety of specialists that may include an advanced practice nurse, physical therapist, spiritual advisor, dietitian or palliative medicine specialist who has extra training in symptom management.
Potentially Severe Side Effects
Although severe side effects are not common, they can occur with certain bladder cancer treatments. Ask your doctor whether any therapies in your treatment plan could cause them, and find out how to identify the symptoms. Report them immediately if they occur. Prompt medical attention can be lifesaving.
- Infection can occur as a result of a low white blood cell count (neutropenia) or other factors. Contact your doctor immediately – do not wait until the next day – if you have any of these symptoms: oral temperature over 100.4 °F, chills or sweating; body aches, chills and fatigue; coughing, shortness of breath or painful breathing; abdominal pain; sore throat; mouth sores; painful, swollen or reddened skin; pus or drainage from an open cut or sore; pain or burning during urination; pain or sores around the anus; or vaginal discharge or itching. If you cannot reach your doctor, go to the emergency room.
- Immune-related adverse events (irAEs) may occur with certain immunotherapy drugs if the immune system becomes overstimulated by treatment and causes inflammation in one or more organs or systems in the body. Some irAEs can develop rapidly, becoming severe and even life-threatening without immediate medical attention.
- Infusion-related reactions most frequently occur with treatments given intravenously (IV) through a vein in the arm and usually happen soon after exposure to the drug. Reactions are generally mild, such as itching, rash or fever. More serious symptoms, such as shaking, chills, low blood pressure, dizziness, breathing difficulties or irregular heartbeat, can be serious or even fatal without medical intervention.
Some Common Side Effects
Some side effects are described in Table 1. They may be more intense when therapies are combined, and not every therapy leads to all these side effects. Talk with your health care team about any that need immediate attention and how to manage the less severe ones if they occur.
Treatment can also impact sexual desire and performance. For assistance, ask for a referral to an appropriate health care professional or support group.
Table 1. Some Common Side Effects of Bladder Cancer Treatment
| Side Effects | Symptoms |
| Anemia | Abnormally low red blood cell count |
| Bleeding in urine or stool | Blood that is visible after urinating or having a bowel movement |
| Blood Clots | Leg discomfort |
| Bowel incontinence | Stool leakage caused by the inability to control bowel movements |
| Bruising or bleeding | Low number of platelets in the blood (thrombocytopenia) |
| Chemo brain (cognitive dysfunction) | Brain fog, confusion and/or memory problems |
| Constipation | Difficulty passing stools or less frequent bowel movements compared to usual bowel habits |
| Decreased appetite | Eating less than usual, feeling full after minimal eating, not feeling hungry |
| Diarrhea | Frequent loose or watery bowel movements that are commonly an inconvenience but can become serious if left untreated |
| Erectile dysfunction | An inability to have an erection adequate for sexual intercourse |
| Eye and vision problems | Blurred vision, dry eyes, eye pain, loss of vision |
| Fatigue | Tiredness that is much stronger and harder to relieve than the fatigue an otherwise healthy person has |
| Hair loss (alopecia) | Hair loss on the head, face and body |
| Infertility | Inability to become or stay pregnant or to father a child |
| Lymphedema | Fluid buildup from lymph node removal that causes swelling |
| Nausea and vomiting | The feeling of needing to throw up and/or throwing up |
| Neuropathy | Numbness, pain, burning sensations and tingling, usually in the hands or feet at first |
| Neutropenia | Low white blood cell count that increases the risk of infection |
| Pain | Pain and aches that occur in the muscles, bones, tendons, ligaments or nerves |
| Respiratory problems | Shortness of breath (dyspnea) with or without cough, upper respiratory infections |
| Sexual dysfunction | Erectile dysfunction, reduced desire or feeling less desirable, vaginal dryness, pain during intercourse |
| Skin reactions | Rash, redness and irritation or dry, flaky or peeling skin that may itch |
| Urinary discomfort | Pain or burning when urinating |
| Urinary incontinence | Inability to control the flow of urine from the bladder |
| Urinary retention | Inability to completely empty the bladder (bladder may feel full even after urinating) |
| Weight loss | Losing weight without trying |
